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A novel nonlinear afterload for ex vivo heart evaluation: Porcine experimental results

Pigot, Henry LU orcid ; Soltesz, Kristian LU orcid ; Paskevicius, Audrius LU ; Liao, Qiuming LU ; Sjöberg, Trygve LU and Steen, Stig LU (2022) In Artificial Organs 46(9). p.1794-1803
Abstract
Background: Existing working heart models for ex vivo functional evaluation of donor hearts often use cardiac afterloads made up of discrete resistive and compliant elements. This approach limits the practicality of independently controlling systolic and diastolic aortic pressure to safely test the heart under multiple loading conditions. We present and investigate a novel afterload concept designed to enable such control. Methods: Six ∼70 kg pig hearts were evaluated in vivo, then ex vivo in left-ventricular working mode using the presented afterload. Both in vivo and ex vivo, the hearts were evaluated at two exertion levels: at rest and following a 20 μg adrenaline bolus, while measuring aortic pressure and flow, left ventricular... (More)
Background: Existing working heart models for ex vivo functional evaluation of donor hearts often use cardiac afterloads made up of discrete resistive and compliant elements. This approach limits the practicality of independently controlling systolic and diastolic aortic pressure to safely test the heart under multiple loading conditions. We present and investigate a novel afterload concept designed to enable such control. Methods: Six ∼70 kg pig hearts were evaluated in vivo, then ex vivo in left-ventricular working mode using the presented afterload. Both in vivo and ex vivo, the hearts were evaluated at two exertion levels: at rest and following a 20 μg adrenaline bolus, while measuring aortic pressure and flow, left ventricular pressure and volume, and left atrial pressure. Results: The afterload gave aortic pressure waveforms that matched the general shape of the in vivo measurements. A wide range of physiological systolic pressures (93 to 160 mm Hg) and diastolic pressures (73 to 113 mm Hg) were generated by the afterload. Conclusions: With the presented afterload concept, multiple physiological loading conditions could be tested ex vivo, and compared with the corresponding in vivo data. An additional control loop from the set pressure limits to the measured systolic and diastolic aortic pressure is proposed to address discrepancies observed between the set limits and the measured pressures. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiac afterload, ex vivo heart evaluation, functional evaluation, heart perfusion, heart transplantation, working heart
in
Artificial Organs
volume
46
issue
9
pages
1794 - 1803
publisher
Wiley-Blackwell
external identifiers
  • scopus:85130399660
  • pmid:35548921
ISSN
0160-564X
DOI
10.1111/aor.14307
project
Functional ex vivo heart evaluation
Hemodynamic Stabilization
language
English
LU publication?
yes
id
22e47e0e-5826-4a1a-b0d3-1ac86aec9a4c
date added to LUP
2022-08-25 10:50:11
date last changed
2024-02-16 19:52:41
@article{22e47e0e-5826-4a1a-b0d3-1ac86aec9a4c,
  abstract     = {{Background: Existing working heart models for ex vivo functional evaluation of donor hearts often use cardiac afterloads made up of discrete resistive and compliant elements. This approach limits the practicality of independently controlling systolic and diastolic aortic pressure to safely test the heart under multiple loading conditions. We present and investigate a novel afterload concept designed to enable such control. Methods: Six ∼70 kg pig hearts were evaluated in vivo, then ex vivo in left-ventricular working mode using the presented afterload. Both in vivo and ex vivo, the hearts were evaluated at two exertion levels: at rest and following a 20 μg adrenaline bolus, while measuring aortic pressure and flow, left ventricular pressure and volume, and left atrial pressure. Results: The afterload gave aortic pressure waveforms that matched the general shape of the in vivo measurements. A wide range of physiological systolic pressures (93 to 160 mm Hg) and diastolic pressures (73 to 113 mm Hg) were generated by the afterload. Conclusions: With the presented afterload concept, multiple physiological loading conditions could be tested ex vivo, and compared with the corresponding in vivo data. An additional control loop from the set pressure limits to the measured systolic and diastolic aortic pressure is proposed to address discrepancies observed between the set limits and the measured pressures.}},
  author       = {{Pigot, Henry and Soltesz, Kristian and Paskevicius, Audrius and Liao, Qiuming and Sjöberg, Trygve and Steen, Stig}},
  issn         = {{0160-564X}},
  keywords     = {{cardiac afterload; ex vivo heart evaluation; functional evaluation; heart perfusion; heart transplantation; working heart}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{9}},
  pages        = {{1794--1803}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Artificial Organs}},
  title        = {{A novel nonlinear afterload for ex vivo heart evaluation: Porcine experimental results}},
  url          = {{http://dx.doi.org/10.1111/aor.14307}},
  doi          = {{10.1111/aor.14307}},
  volume       = {{46}},
  year         = {{2022}},
}